Fatal Meningitis Following Reduction Malarplasty: A Previously Unreported Complication.

Area of Science:

• Plastic Surgery
• Neurosurgery
• Infectious Diseases

Background:

• Reduction malarplasty is a cosmetic surgical procedure to reduce cheekbone prominence.
• Major complications are uncommon and typically not life-threatening.
• Intracranial infectious complications following this procedure have not been previously reported.

Purpose of the Study:

• To report a fatal case of postoperative meningitis after reduction malarplasty.
• To highlight the potential risk of intracranial infection associated with this procedure.
• To emphasize the importance of surgical precision and early diagnosis.

Main Methods:

• Case report of a 35-year-old female patient presenting with altered mental status.
• Review of clinical presentation, imaging (craniofacial), and laboratory findings.
• Analysis of potential surgical factors contributing to the complication.

Main Results:

• The patient developed bacterial meningitis with intracranial involvement approximately two weeks post-revisional reduction malarplasty.
• Imaging suggested possible dural violation by fixation hardware, potentially creating a route for infection.
• The complication was fatal, underscoring the severity of intracranial infections.

Conclusions:

• Reduction malarplasty, while generally safe, carries a rare risk of fatal intracranial infections.
• Meticulous surgical planning and accurate fixation are critical to avoid dural penetration.
• Prompt recognition and management of neurological symptoms are essential for improved patient outcomes.